Abstract
BackgroundSpinal cord lesions is one of the predominant characteristics in patients with neuromyelitis optica spectrum disorders (NMOSD). Interestingly, mounting evidence indicates that spinal cord atrophy (SCA) is one of common clinical features in multiple sclerosis (MS) patients, and correlates closely with the neurological disability. However, Clinical studies related to the SCA aspects of NMOSD are still scarce.MethodsWe retrospectively analyzed 185 patients with NMOSD, including 23 patients with SCA and 162 patients without SCA. Data were collected regarding clinical characteristics, laboratory tests, and magnetic resonance imaging findings.Results12.4% of patients had SCA in NMOSD. Patients with SCA had a longer disease duration and higher EDSS at clinical onset and last visit. More importantly, SCA patients were more prone to reach disability milestones (EDSS ≥ 6.0). Bowel or bladder dysfunction, movement disorders, and sensory disturbances symptoms were more common in patients with SCA. ESR and CRP were significantly higher in patients with SCA than those without SCA. Patients with SCA were more frequently complicated with cervical cord lesions. However, the ARR, progression index, seropositive rate of NMO-IgG and OCB were similar in the two groups. Futhermore, LETM did not differ significantly between patients with SCA and without SCA in NMOSD patients.ConclusionsPatients with SCA might have longer disease duration, more severe clinical disability, and more frequently complicated with cervical spinal cord lesions. SCA might be predictive of the more severe neurologic dysfunction and worse prognosis in NMOSD. Inflammation contributes to the development of SCA in NMOSD.
Highlights
Spinal cord lesions is one of the predominant characteristics in patients with neuromyelitis optica spectrum disorders (NMOSD)
Patients We retrospectively reviewed the medical records of 185 patients with NMOSD (23 patients with spinal cord atrophy (SCA) and 162 patients without SCA) who were hospitalized at the multiple sclerosis (MS) center of the Third affiliated hospital of Sun Yat-sen University between March 2008 and September 2013
Relapses were defined as new or recurrent neurologic symptoms not associated with fever or infection that lasted ≥24 h and were accompanied by new neurologic signs found by the examining neurologist
Summary
Spinal cord lesions is one of the predominant characteristics in patients with neuromyelitis optica spectrum disorders (NMOSD). Mounting evidence indicates that spinal cord atrophy (SCA) is one of common clinical features in multiple sclerosis (MS) patients, and correlates closely with the neurological disability. Clinical studies related to the SCA aspects of NMOSD are still scarce. The current studies indicate atrophy is a common pattern during the disease course and a potential marker of clinical disability in all subtypes of multiple sclerosis (MS) [7,8,9]. Spinal cord atrophy (SCA), atrophy of cervical cord, is considered to contribute to accumulation of disability and clinical outcome [7,10]. Little attention has been paid to exploring the clinical features of SCA in NMOSD.
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